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Block 2 Molecular Medicine (Pharmacology)

Total questions: 11

Worksheet time: 17mins

Name
Class
Date
1.

The neonatal brain may accumulate toxic levels of drugs because

a)

Cytochrome P450 enzymes are nonfunctional.

b)

The blood-brain barrier is not fully developed.

c)

The P-glycoprotein transporter is overdeveloped.

d)

Gastric motility and peristalsis are delayed.

2.

A 68-year-old woman was prescribed fluoxetine, an antidepressant drug. The doctor was concerned that she might develop prolonged effects of the medications. Which ONE of the following pharmacokinetic factors is the likely reason for his concern?

a)

Decrease in glomerular filtration rate

b)

Reduce bioavailability of drug

c)

Increase in hepatic metabolism

d)

Increase in bound fraction of drug

3.

A 72-year-old man was taking a β-adrenergic receptor antagonist to control his hypertension for several years, but it has lost efficacy. A possible reason for this is that

a)

The sensitivity of these receptors to drug decreases with age.

b)

Increased body fat increases the volume of distribution of the drug.

c)

Increased serum albumin leads to more drug sequestered in the circulation.

d)

Enhanced glomerular filtration clears the drug faster.

4.

A patient’s pharmacogenetic laboratory test report shows that he is a CYP2D6 poor metabolizer. He is prescribed Tylenol with codeine for an ankle sprain. What is the effect of CYP2D6 poor metabolizer phenotype on codeine?

a)

Patient may experience increased side effect

b)

Patient may experience decreased efficacy

c)

Patient may have increased exposure to the metabolite

d)

Patient may need to reduce the dose

5.

Which one of the following drugs will NOT cause bone marrow toxicity in individuals overexpressing the Thiopurine-S-methyltransferase enzyme?

a)

Azathioprine

b)

Tioguanine

c)

Mesalamine

d)

Mercaptopurine

6.

A 32 years old female patient was admitted to the hospital for laparoscopy combined with hysteroscopy exploration. A general anaesthesia with intubation to the patient was performed. Succinylcholine was administered in anaesthesia induction and cisatracurium and sevoflurane were used for anaesthesia maintenance. A plasma cholinesterase deficiency patient will

a)

undergo slow metabolic degradation of cisatracurium

b)

be susceptible to prolong respiratory paralysis

c)

terminate the action of succinylcholine rapidly

d)

be at higher risk of neurotoxicity

7.

A 25-year-old Egyptian woman was prescribed isoniazid and rifampicin for the treatment of tuberculosis. A quick pharmacogenetic test revealed that she is a slow acetylator. Which ONE of the following adverse effects is most likely will happen in this woman?

a)

Peripheral neuropathy

b)

Myelotoxicity

c)

Arrhythmia

d)

Pulmonary fibrosis

8.

A 15-year-old boy was diagnosed with focal epilepsy. An attending physician decided to prescribe an anti-epileptic drug that can induce Stevens-Johnson syndrome in patient with HLA-B*1502 allele. Which of the following drugs is prescribed to the patient?

a)

Carbamazepine

b)

Valproic acid

c)

Codeine

d)

Omeprazole

9.

A patient is treated with an immunosuppressant drug following a liver transplant. The drug is known to bind to cyclophilin and inhibit the actions of calcineurin. For what drug toxicity should this patient be monitored?

a)

Pulmonary fibrosis

b)

Hypotension

c)

Hypoglycemia

d)

Nephrotoxicity

10.

IL-2 is a cytokine that is produced by T cells, and also exerts autocrine effects to stimulate T cell replication. Which of the following agents is a selective antagonist for the IL-2 receptor expressed on the cell surface of T cells?

a)

Belatacept

b)

Prednisolone

c)

Basiliximab

d)

Sirolimus

11.

The level of immunosuppression is sometimes not achieved with a combination of a calcineurin inhibitor and an antimetabolite following an organ transplant. In this case, adding an mTOR inhibitor can be beneficial because of their different mechanism of action, which can produce a synergistic effect. An example of this drug class is

a)

Azathioprine

b)

Everolimus

c)

Mycophenolate mofetil

d)

Tacrolimus